On 10 August 2019, the sex trafficking case against Jeffrey Epstein took a dramatic turn when the corpse of the sixty-six-year-old billionaire was discovered in his New York prison cell. The cause of death immediately became a matter of fierce debate. Suicide according to most observers, murder according to some adepts of conspiracy theories. Although the autopsy finally pointed to suicide by hanging, it is likely that the publication of the medical examiner’s conclusions will probably not convince those who stubbornly maintain that Epstein was killed on behalf of one of his rich and powerful ‘partners in crime’.
Scepticism regarding the cause of death of alleged suicides is certainly not a modern phenomenon, and one might expect that it was even more of a concern in the early modern period, when ‘self-murder’ was still considered a felony, with punishments including desecration of the suicide’s corpse together with the confiscation of his or her goods. Thus relatives had a clear interest in hiding suicides from the legal authorities. Two questions therefore arose: Was an alleged suicide by hanging a real suicide, or a camouflaged homicide? And were all accidental deaths really accidental? The early modern period witnessed an important medico-legal debate on the question of how to distinguish suicidal deaths, especially hangings, from homicidal deaths staged as suicides. Starting with the Traité de Rapports (1575) of the French surgeon Ambroise Paré (ca. 1510-1590), the first vernacular treatise on legal medicine, medico-legal theorists went to a lot of effort to establish the signs by which one could determine whether a person had hanged himself, or whether his corpse was hanged after death in order to simulate a suicide.
In 1763, the French professor of surgery Antoine Louis (1723-1792) published a treatise devoted exclusively to how to “distinguish, when a corpse is found hanged, the signs of suicide from those of murder”. The immediate impetus for writing this work was the notorious affaire Calas, involving the wealthy Huguenot merchant Jean Calas, who was executed on behalf of the Parliament of Toulouse in 1762 for having strangled his son Marc-Antoine, who was supposedly wanting to convert to Catholicism. The case was strongly influenced by religious hatred towards the local Protestant community, and supported by a dubious autopsy report written by local medical practitioners. After a polemical campaign spearhead by Voltaire, Jean Calas was posthumously rehabilitated in 1765. In order to avoid similar unjust charges in the future, Louis deemed it necessary to clearly lay out the signs distinguishing a genuine suicidal hanging (which Louis considered to be the real cause of Marc-Antoine’s death) from a camouflaged homicide. According to Louis, an examination for external signs of hanging (such as the imprint of a rope, the presence of mucus and saliva in nose and mouth, and a blackened, swollen tongue) always had to be supplemented by a thorough dissection of the neck in order to discover injuries that might point to external violence.
Nonetheless, in eighteenth-century Flanders, the region I study for my own doctoral research, Louis’ advice was only partially followed. Dissections of hanged bodies were extremely rare, and the physicians and surgeons consulted by the authorities usually limited themselves to observations regarding the presence of a clear imprint of a rope or cord around the neck, and the absence of other external injuries.
However, the term ‘suicide’ almost never appears in the expert’s reports. Early modern medical practitioners were very careful to limit themselves exclusively to the medical cause of death (strangulation by a cord or rope), leaving the legal qualification – suicide – to the judicial authorities. The absence of similar qualifications in the majority of reports was eagerly exploited by the lawyers who were required to defend the corpses of suicides at trial. The fact that such a report did not explicitly state that the victim killed him- or herself was used to cast doubt on the actual cause of death. In 1715, for instance, the body of the horse thief Francies Vande Kerckhove was discovered in his cell in the town prison of Aalst. According to the medical practitioners who examined the body, a hole had been stabbed in Vande Kerckhove’s head with a nail. Inside the wound, the examiners discovered a straw, the presence of which had caused an ulceration in the brain, and which had finally resulted in the prisoner’s death. While the legal authorities concluded that Vande Kerckhove had stabbed himself in the head with a nail and inserted a straw in the wound, the lawyer designated to defend the corpse maintained that nothing in the report demonstrated that the wound in question had been self-inflicted.
While this argumentation did not convince the judges, and Vande Kerckhove’s body was posthumously punished, allegations of this kind routinely appeared in eighteenth-century suicide trials, although the defendants gradually discovered a much more effective way to obtain the ‘acquittal’ of suicides: the so-called ‘insanity defence’. As suicides were only punished when committed intentionally, the bodies of those who killed themselves in a state of permanent or temporary insanity were mostly left unharmed and permitted burial in consecrated ground. Over the course of the eighteenth century, suicidal acts gradually became ‘medicalised’, meaning that more and more self-killings were considered the consequence of mental pathologies rather than rational intent or diabolical temptation. In turn, this process of medicalisation – in which medical practitioners in fact only played a marginal role – resulted in an increase in acquittals and a de facto decriminalisation of suicide. Finally, in 1782, Emperor Joseph II officially decriminalised suicide within the Habsburg Netherlands. While this definitively put an end to actual suicide trials, public controversies regarding the actual causes of death of alleged suicides have proven much more resilient.
State Archives Ghent, Archives of the Council of Flanders, no. 169, fol. 148v-154v: Trial against the corpse of Francies Vande Kerckhove (February 1715).
Louis, Antoine. Verhandeling over een ontleedkundig geschil, tot de rechtsgeleerdheid betrekkelyk, waar in de grondregelen om, op het aanschouwen van een hangend gevonden dood lichaam, de kenmerken van Zelfsmoord, van die van Manslag te onderscheiden, translated by Isaac Le Roy. Amsterdam: Petrus Conradi, 1775.
Bosman, Machiel. “The Judicial Treatment of Suicide in Amsterdam.” In From Sin to Insanity. Suicide in Early Modern Europe, ed. Jeffrey R. Watt: 9-24. Ithaca: Cornell University Press, 2004.
Deschrijver, Sonja. “From Sin to Insanity? Suicide Trials in the Spanish Netherlands, Sixteenth and Seventeenth Centuries.” Sixteenth Century Journal 42, no. 4 (2011): 981-1002.
Macdonald, Michael. “The Medicalization of Suicide in England. Laymen, Physicians and Cultural Change, 1500-1870.” In Framing Disease. Studies in Cultural History, eds. Charles E. Rosenberg and Janet Golden: 85-103. New Brunswick: Rutgers University Press, 1992.
Watt, Jeffrey R. Choosing Death. Suicide and Calvinism in Early Modern Geneva. Kirksville: Truman State University Press, 2001.